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HOW TO BE AN AMAZING FIRST YEAR PG IN SURGERY? - PART II ( ACADEMICS & STUDYING DURING RESIDENCY)

I have always enjoyed interacting with surgical residents and one of the first questions the young resident who enters surgery asks me is “ How do I study during residency?” Studying during a tough surgery residency is not easy at all. The biggest hurdle will be your seniors and colleagues who will discourage you from picking your books. The long hours, lack of sleep and abusive seniors  just compound things. But one fact we forget is - studying in residency is not a privilege, it's a duty. Acquiring knowledge so that you can treat your patients appropriately is a fundamental duty. 

This article will be a continuation to Part I of being an amazing surgical resident. 


 





HOW TO STUDY DURING PG LIFE?


IN THE WARD: 

The best surgical atlas an Indian resident can have is the patient himself. The good caseload in most Indian centres means that there is no dearth of surgical material. The optimal way to start studying is to read about the cases in the ward everyday.     The moment a case is admitted in the ward, pick up your Washington Manual of Surgery and start reading about it. The Washington Manual can be used as an e-book on your phone or tab. The Washington Manual of surgery is a small and concise handbook that doesn’t delve too much into theoretical aspects of surgery but merely lists out the concepts, diagnosis and management of a particular problem. Residents who can afford to shell out significant chunks of money can also spend on UptoDate. UpToDate is one of the best resources a resident can subscribe to. 



Keep in touch with recent research. Just type in the keywords on NCBI/Pubmed website and checkout the most appropriate research paper. Even if time doesn’t permit you the read the entire paper, read the abstract and try to understand it. 



IN THE OPERATING THEATRE:

The operating theatre can be quite intimidating as a first year resident. One of the best ways to come out unscathed out of the OR is to read well before surgery. Use Farquharson's Textbook of Operative General Surgery to read upon on the operating steps. If you have time to read the previous night, use Fischer's Mastery of Surgery 7th edition. Fischer’s is a fantastic resource which explains the anatomy and the surgery in detail. For a first year resident, it might seem like a humongous task to go through it. But the effort you put into understanding the concepts in Fischer’s will reflect on your operating table. 



For understanding the basic principles of surgery use Kirk’s Basic Surgical Techniques 6th edition . This book will teach you the methods of knot tying, suturing, fixing a drain and inserting a chest tube. 


However the best resource for operative surgery is YOUTUBE. The absolute wealth if content YouTube offers you is unsurpassed and the only hurdle will be in dis time ting between good quality content and useless videos. 


The NCCN guidelines are the most important resource a resident can use before treating a patient with a malignant condition 


YOUTUBE CHANNELS TO FOLLOW:


https://www.youtube.com/channel/UCVpqNpkdJtxqSDw8C2Lw4XA - The official channel for Learning General Surgery. The ultimate resource on surgical knowledge especially after the lockdown lecture series. LGS videos are extremely well curated

by Dr GD Sharma and Dr Patta Radhakrishna




https://www.youtube.com/c/SurgicalEducator - Basics of surgery - essential for every resident 


https://www.youtube.com/c/Surgery101 - Surgery basics explained in simple terms 


https://www.youtube.com/c/SAGESVideo - SAGES channel. Follow for high quality laparoscopy training 


https://www.youtube.com/channel/UCTOg68oXp2S-yIPz0tkTewA - Operative surgical oncology by Dr Marimuthu of Thanjavur, Tamil Nadu


https://www.youtube.com/user/surgyserg - Follow the Ukrainian maestro Dr Baydo for daredevil laparoscopy 


https://www.youtube.com/channel/UCVpqNpkdJtxqSDw8C2Lw4XA - Dr Omedary teaches us how to tie surgical knots 


https://www.youtube.com/channel/UCE1sLGb-8COMdl0_xkdxD3w - Dr Ashwin’s laproscopic Hernia videos are a must watch


I can keep talking about wonderful surgeons on YouTube. Really soon we will do a separate exhaustive post on YouTube channels for surgery residents. 



BOOKS YOU SHOULD BUY 


Bailey and Love Short Practice of Surgery, 27th edition - Read basic aspects of surgery and urology from bailey. You need nothing more for final exams and also NEET SS




Sabiston Textbook of Surgery, 20th edition - GI Surgery is best read from Sabiston,. It is quite exhaustive and an absolute deligh to read. Residents interested in GI surgery should never complete residency without reading  Sabiston. 




Schwartz Principles of Surgery, 11th edition - Breast and Thyroid chapters are extremely detailed and thorough in this masterpiece. A definite must-read. 


                                                          

 

Clinical Surgery Pearls 3rd edition by Dr Dayananda Babu   This book is the living soul of every resident preparing for final year exams. For clinical surgery, this is no-brainer. You should definitely purchase the hard copy. 



Bedside Clinics in Surgery 3rd edition by Dr Makhan Lal Saha - This beauty of a book is a lifesaver in final year examinations. Certain chapters like abdomen examination are never omitted. 




A Manual On Clinical Surgery by S.Das 14th edition. This book is now in its 14th edition but shall never go out of favour. You would be committing a sin if you don't read ulcer and swellings from this evergreen book. Note: Even if you possess an older edition, it doesn’t matter - Nothing ever changes in successive editions. 


Separate posts will cover books that GI surgery, Onco surgery, Neurosurgery and Plastic aspirants should buy.


APPs 


I used to read Bailey during my PG days and would always wish that I has an application on which I could solve MCQs so that I could simultaneously prepare for NEET SS. There were a couple of web based options but none were good for daily use in the ward. I ended up developing the SURGTEST app with a group of friends so that residents could use a handy app that would work even at low internet speeds in dimly lit, dungeon-like wards with a whole host of network issues. The general surgery question bank with more than a thousand questions based on Bailey and Love 27th edition are exhaustive and a must-have for every first year surgery resident. The questions are arranged topic wise and will help you revise core topics at ease. The Onco surgery question bank based on MD Anderson Surgical Oncology Handbook 6th edition and NCCN guidelines should be on the wish list of every resident aspiring to be an hot shot onco-surgeon. The GI surgery package is about to be released soon. There are also extensive video lectures on GI surgery which would be an invaluable resource on GI surgery for residents. Residents can contact the team for discounts. 


                                                              


I have covered a few aspects of studying during residency. In future chapters, I will cover research during residency, negotiations seniors and diplomacy while a resident and a few other topics. Since it is an extensive topic, I have not covered MRCS preparation. MRCS preparation is definitely possible even while you are a resident and I am gonna tell you how to crack both parts of MRCS even before you finish MS/DNB.


There is nothing more satisfying than treating the patient the right way. The patient puts his/her full trust on you. It is extremely essential that we understand this. It is a huge privilege to be a surgeon. That privilege comes with a huge responsibility. One major aspect of that responsibility is acquiring knowledge.


Learn well. Treat well.


Vinayak Rengan is a General surgeon from Chennai who completed his Surgical residency at Madras Medical College. He is a compulsive news junkie who regularly writes for print media and runs a blog The Stonebench where he writes on technology, public health and politics . He is the co-founder of Surgtest - a surgical education platform which helps surgeons prepare for NEET SS and MRCS.


#neetss #surgery #residency #indiaPG #Generalsurgery





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